Provider Demographics
NPI:1922103597
Name:BILLINGS IMAGING
Entity Type:Organization
Organization Name:BILLINGS IMAGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:BENNION
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MD
Authorized Official - Phone:406-655-2373
Mailing Address - Street 1:152 S 32ND ST W
Mailing Address - Street 2:SUITE B
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-6848
Mailing Address - Country:US
Mailing Address - Phone:406-655-2373
Mailing Address - Fax:406-655-2271
Practice Address - Street 1:152 S 32ND ST W
Practice Address - Street 2:SUITE B
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-6848
Practice Address - Country:US
Practice Address - Phone:406-655-2373
Practice Address - Fax:406-655-2271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT5246261QS0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0112XAmbulatory Health Care FacilitiesClinic/CenterOral and Maxillofacial Surgery